Next on New York’s health agenda: curbing salt intake

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© Don Carstens - The Stock Connect/Science Faction/Corbis

In recent years New York City has earned a reputation for ambitious—and some argue, overreaching—efforts to improve its’ citizens health. In 2006, the city’s Board of Health voted to ban trans fats in restaurant cooking. Two years later, they mandated that any restaurants with 15 or more chain locations post calorie content in their menus. In 2003, the Smoke Free Air Act went into place in the Big Apple, making “virtually all work places smoke-free,” and this past fall, city health commissioner Dr. Thomas A. Farley expressed his desire to move the smoking ban outdoors too, to city parks and beaches. Now the latest target in New York’s battle to improve public health may be the public’s penchant for salty snacks. The initiative, under development for the past year, and announced today, seeks to reduce sodium levels in packaged foods and restaurant dishes by 25% in the next five years—a reduction that health officials say will result in 20% less salt consumption.

The National Salt Reduction Initiative, as this campaign is known, is led by New York City and championed by Farley, but includes public health organizations from several different cities (including Boston, Chicago, Los Angeles, Philadelphia, Seattle) and states (including Alaska, Delaware, Michigan, North Carolina, Tennessee). Farley and fellow health officials point out that currently 80% of the salt Americans consume is already added to food before we buy it off the shelf, meaning that often, through our regular eating habits, we may meet or often surpass our daily recommended salt intake before we’ve even picked up the shaker. On average, Americans consume as much as 12 grams of salt each day, or roughly twice the recommended amount.

All that extra salt increases the risk for high blood pressure, heart disease and stroke, resulting in an estimated 23,000 deaths each year in New York City alone, and some 800,000 nationwide. Physicians have long advised patients against eating too much salt, but, as a society, the rate at which we scarf up sodium has steadily increased for the past 40 years—by some 50%. Most of that increase, health officials and researchers say, is attribute to the high concentrations of sodium in packaged foods.

So, developing an initiative that seeks to target sodium levels at the source—with food manufacturers—makes sense, but how cooperative is the food industry likely to be with this voluntary campaign, especially given the fact that Americans have grown accustomed to, well, extra salty food? Leaders of the initiative point to previous success in the U.K., where a similar collaboration between public health organizations and food manufacturers successfully resulted in a 40% reduction in salt content for many food products. What’s more, they say, because of the five-year roll-out, manufacturers will be able to slowly, and subtly, taper their salt content—ideally keeping their customers happy, while simultaneously providing them with healthier products.

At least, that’s the hope. Yet, whether or not food manufacturers will eagerly sign up for the initiative does not diminish the health risks posed by consuming so much salt, or the benefits of cutting back. As Dr. Kirsten Bibbins-Domingo, an epidemiologist at the University of California, San Francisco, told TIME last spring, if Americans could even make incremental reductions in their salt intake—cutting out as little as 1 gram of salt per day—as many as 200,000 lives could be saved over the course of a decade. And telling people to cut back just isn’t going to cut it, Bibbins-Domingo said. “It’s so pervasive in an average U.S. diet that it’s really hard to tell people, ‘You have to avoid salt.'”

Of course, as with the other New York City public health campaigns, despite its initially voluntary nature, this too will undoubtedly provoke criticism from those who believe it’s just another example of the government overreaching into people’s personal choices. Yet former New York City health commissioner and current director of the Centers for Disease Control, Dr. Thomas Frieden, who began the salt-reduction initiative, addresses critics by framing the debate in a slightly different way. Discussing opposition to salt-reduction efforts, he dryly posed the question to TIME last spring, “Should industry be allowed to serve us food that makes us sick and kills us?”